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Genetics: Younger kids are predisposed if their parents have a migraine condition. If one parent has migraines, there is a 40 percent risk that the child will get them, according to the Diamond Headache Clinic. If both parents experience migraines, the probability of the child getting them rises to 70 percent.

Stress: “Nowadays, society is just way too busy and over-stimulated and stressed. People with sensitive nervous systems are easily affected by anything that causes adrenaline to speed up,” Diamond said. “All the medicine in the world isn’t going to help if you’re still going 100 mph because the body needs a cool-down time so it can detoxify.”

Her clinic sees an influx of adolescent patients at the beginning and end of the academic year, when anxiety over homework and extracurriculars is the greatest. This held true for Jennie Kamrath. Her migraines were not nearly as pronounced on the weekends and during extended breaks from school.

Diet: Certain foods or beverages with caffeine, chocolate, yellow cheeses, nitrates, artificial sweeteners and additives can aggravate the condition. And for many children and adolescents, these processed, sugary items are consumed in large quantities, which has unsettling biochemical consequences, Diamond said.

Also, the timing of meals can play a role. “For some of my kids I take care of, this is a big issue,” Diamond said. “They’re getting up at 6:30, 7, eating, and then eating again at 10:30 if they have an early lunch period. They may not have food again until after 4, and that’s a long time to go without caloric intake.”

Sleep: An irregular pattern or an inadequate number of hours can do a lot of harm for those who experience migraines, Sperry said. Again, anything interrupting the physiological norm will have health ramifications.

Light: Bright or fluorescent lighting is the kiss of death, Jennie Kamrath said.

Odors: Overpowering scents such as cleaning products, perfumes, smoke and chlorine can activate migraines, too, Sperry said.

Hormones: Before puberty, boys and girls experience chronic headaches equally, according to the Diamond Headache Clinic. But after teen girls begin menstruating, they are three times more likely to suffer from them than their male classmates because of the hormonal shifts.

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A lot of people get migraines — about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.

A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear.

Scientists used to believe that migraines were due to changes in blood vessels within the brain. Today, most medical experts believe the attack actually begins in the brain itself, where it involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine attacks may be triggered by:

* Alcohol
* Allergic reactions
* Bright lights
* Certain odors or perfumes
* Changes in hormone levels (which can occur during a woman’s menstrual cycle or with the use of birth control pills)
* Changes in sleep patterns
* Exercise
* Loud noises
* Missed meals
* Physical or emotional stress
* Smoking or exposure to smoke

Certain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:

* Any processed, fermented, pickled, or marinated foods
* Baked goods
* Chocolate
* Dairy products
* Foods containing monosodium glutamate (MSG)
* Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
* Fruits (avocado, banana, citrus fruit)
* Meats containing nitrates (bacon, hot dogs, salami, cured meats)
* Nuts
* Onions
* Peanut butter

This list may not be all-inclusive.

True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition.

Symptoms

Vision disturbances, or aura, are considered a “warning sign” that a migraine is coming. The aura occurs in both eyes and may involve any of all of the following:

* A temporary blind spot
* Blurred vision
* Eye pain
* Seeing stars or zigzag lines
* Tunnel vision

Not every person with migraines has an aura. Those who do usually develop one about 10-15 minutes before the headache. However, it may occur just a few minutes to 24 hours beforehand.

Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The headaches usually:

* Feel throbbing, pounding, or pulsating
* Are worse on one side of the head
* Start as a dull ache and gets worse within minutes to hours
* Last 6 to 48 hours

Other symptoms that may occur with the headache include:

* Chills
* Increased urination
* Fatigue
* Loss of appetite
* Nausea and vomiting
* Numbness, tingling, or weakness
* Problems concentrating, trouble finding words
* Sensitivity to light or sound
* Sweating

Symptoms that may linger even after the migraine has gone away include:

* Feeling mentally dull, like your thinking is not clear or sharp
* Increased need for sleep
* Neck pain

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If you are approaching the menopause and find you are suddenly suffering from extreme headaches, you are not alone. Almost half of the women that I speak to develop perimenopausal migraines, and I find they are one of the most debilitating Menopause Symptoms. While any women approaching the menopause can experience these headaches, they can be particularly severe in women that go through Early Menopause following surgery.

These headaches are largely caused by fluctuating hormone levels, with decreasing estrogen levels affecting the chemicals in the brain that cause headaches. To stabilise your hormone levels, your doctor may recommend Hormone Replacement Therapy, which can be an effective treatment. However, you should be aware that in some cases Hormone Replacement Therapy can actually make perimenopausal migraines worse, in which case you might want to consider alternative natural treatments.

Here are a few of the strategies I can recommend to reduce menopause headache symptoms:

- Keep a food diary to identify headache triggers such as MSG, chocolate, alcohol or caffeine.
- Learn relaxation techniques and try to reduce your stress levels.
- A massage with lavender or chamomile oil can relax you and stimulate the release of endorphins, your own natural pain killers.
- Make sure you get enough sleep and try to keep your sleep patterns consistent.
- Try holistic treatments such as acupuncture, which has a high success rate in reliving menopausal headaches.

You should find that your migraines improve once you actually enter the menopause and your hormone levels stabilise. However, you may experience tension headaches which can also be relieved using the above treatments.

Note:

The information contained in this post is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Always consult your doctor or health care specialist before taking any medical advice or if you are in any way concerned about your physical wellbeing.

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Triggers are not direct causes of the headache, but they facilitate or provoke the beginning of an attack. Anything that stimulates the pain receptors in the head and neck can cause a headache.

Some of the more common triggers for headache:

* Emotional triggers: problems at work, success at work or school, anticipation, anxiety, an emotional crisis, a new job. Emotions can bring on headaches, keep them going, and make them worse. Emotions don’t cause your headaches, they just make you more vulnerable to them.
* Environmental triggers: bright light, different kinds of aromas like perfume, tobacco, odors (such as gasoline), loud noises, altitude, barometric pressure changes.
* Stress triggers: strenuous exercise, excessive physical work at the work place or at school, physical sickness, not enough sleep or too much sleep
* Chemical triggers: changes in hormone levels (that occur during the premenstrual period, during the post-menstrual period), low blood sugar.
* Food and beverage triggers: caffeine, alcohol (especially red wine), hard cheese, vinegar, hot dogs, chocolate, nuts, MSG (monosodium glutamate), pizza, pork. Foods containing nitrites as preservatives can also trigger headaches. Fasting or missing meals is a major headache trigger.
* Changes in the weather can change body chemistry, and have been known to trigger headaches.
* Heavy cigarette smoking.

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There’s no cure for cluster headaches. The goal of treatment is to help decrease the severity of pain and shorten the headache period.

Acute medication

The purpose of acute treatment is to stop or reduce pain after a cluster headache starts. Because the headache peaks quickly, acute medications must be fast-acting and delivered quickly, using an injection or inhaler rather than oral tablets. You must be ready to take the medication as soon as an attack starts. And you may want to teach family members about your medications so that they’ll be able to help you when you have an attack.

Because the pain of a cluster headache comes on suddenly and may subside within a short time, over-the-counter pain relievers such as aspirin or ibuprofen (Advil, Motrin, others) aren’t effective. The headache is usually gone before the drug starts working. Fortunately, other types of acute medication can provide some pain relief. Treatment of cluster headache is focused more on prevention, with more medication options available to choose from.

Acute treatments include:

* Oxygen. Briefly inhaling 100 percent oxygen through a mask at a rate of 6 to 8 liters a minute provides dramatic relief for most who use it. Occasionally, a higher flow rate may be more effective. The effects of this safe, inexpensive procedure can be felt within 15 minutes. The major drawback of oxygen is the need to carry an oxygen cylinder and regulator with you, which can make the treatment inconvenient and inaccessible at times. Small, portable units are available, but some people still find them impractical. Sometimes, oxygen may only delay rather than stop the attack, and pain may return.
* Sumatriptan. The injectable form of sumatriptan (Imitrex), which is commonly used to treat migraine, is also an effective acute treatment for cluster headache. Some people may benefit from using sumatriptan in nasal spray form, but for most this is not as effective as an injection. Sumatriptan isn’t recommended for people with uncontrolled high blood pressure or ischemic heart disease.

Another triptan medication can be taken orally for relief of cluster headache. Although oral meds isn’t as effective as injectable sumatriptan, it may be an option for people who can’t tolerate other forms of acute treatment.

* Dihydroergotamine. This ergot derivative is available in intravenous, injectable and inhaler forms. Dihydroergotamine (D.H.E. 45, Migranal) is an effective pain reliever for some people with cluster headache. When administered intravenously, the drug requires you to go to a hospital or doctor’s office to have an intravenous (IV) line placed. The inhaler form of the drug works more slowly. The dosage must be limited to avoid side effects, especially nausea.
* Octreotide (Sandostatin, Sandostatin LAR). This drug, a synthetic version of the brain hormone somatostatin, has traditionally been used to control severe diarrhea. However, some studies have shown that the injectable form is an effective treatment for cluster headache and is safe for people with high blood pressure and ischemic heart disease.
* Local anesthetics. The numbing effect of local anesthetics may be effective against cluster headache pain when used in the form of nasal drops.

Surgery

Rarely, surgery is recommended for people with chronic cluster headache who don’t respond well to aggressive treatment or who can’t tolerate the medications or their side effects. Candidates for surgery must have headaches only on one side of the head because the surgery can be performed only once. People with headaches that alternate sides of the head risk the chance that the procedure will be unsuccessful.

Several types of surgery have been used to treat cluster headache. These procedures attempt to damage the nerve pathways thought to be responsible for pain. However, residual muscle weakness in your jaw or sensory loss in certain areas of your face and head may result. The most common procedures are directed at the trigeminal nerve. They include:

* Conventional surgery. Using a conventional invasive procedure, your surgeon cuts part of the trigeminal nerve with a scalpel or uses small burns to destroy part of the nerve. This form of surgery provides relief for most people with chronic cluster headache.
* Radiosurgery. In a procedure called radiosurgery, a focused beam of radiation is used to destroy part of the trigeminal nerve. Radiosurgery is a noninvasive procedure that may have fewer side effects than does conventional surgery, but some studies have questioned the effectiveness and permanency of the results.

Potential treatments

As scientists learn more about the causes of cluster headache, they’re able to develop more selective treatments for the condition. One development that shows promise is the use of a device to stimulate the occipital nerve, which influences the trigeminal nerve. To treat people with frequent cluster headaches, researchers are testing a stimulator — a pacemaker-sized device that sends impulses via electrodes — that is implanted over the occipital nerve. A Mayo Clinic study of implanted occipital nerve stimulators found that the devices reduced chronic headache pain by an average of about half.

Similar research is under way using an implanted stimulator in the hypothalamus, the area of the brain associated with the timing of cluster periods. Stimulation of the hypothalamus in a small number of people with severe, chronic cluster headaches has produced complete and long-term pain relief with no significant side effects.

In addition, researchers are studying new medications for use in treating and preventing cluster headache.

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Hormonal birth control (birth control pills) may not work as well while you are using Esgic-Plus . To prevent pregnancy, use an extra form of birth control (condoms).

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Esgic-Plus while you are pregnant. Esgic-Plus is found in breast milk. Do not breast-feed while taking Esgic-Plus .

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Acetaminophen, butalbital, and caffeine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

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There are many possible triggers of tension headache. You may have no identifiable or consistent trigger, or have several obvious ones. Potential triggers include:

* Stress
* Depression and anxiety
* Lack of sleep or changes in sleep routine
* Skipping meals
* Poor posture
* Working in awkward positions or holding one position for a long time
* Lack of physical activity
* Occasionally, hormonal changes related to menstruation, pregnancy, menopause or hormone use
* Medications used for other conditions, such as depression or high blood pressure
* Overuse of headache medication

Half the people with tension headache report that they felt stressed or hungry before their headache began.

Tension headache may be made worse by jaw pain from clenching or grinding teeth (bruxism) or by head trauma, such as a blow to the head or whiplash injury. People with stiff joints and muscles due to arthritis of the neck or inflammation of the shoulder joints may develop tension headache.

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Fasting possibly may precipitate migraine headaches by causing the release of stress-related hormones and lowering blood sugar. Therefore, migraine sufferers should avoid prolonged fasting.

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Examples of triggers include stress, sleep disturbances, fasting, hormones, bright or flickering lights, odors, cigarette smoke, alcohol, aged cheeses, chocolate, monosodium glutamate, nitrites, aspartame, and caffeine.

For some women, the decline in the blood level of estrogen during the onset of menstruation is a trigger for migraine headaches.

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Hormones may also trigger migraine. Some women who suffer from migraine headaches experience more headaches around the time of their menstrual periods. Other women experience migraine headaches only during the menstrual period. The term “menstrual migraine” is used mainly to describe migraines that occur in women who have almost all of their headaches from two days before to one day after their menstrual periods. Declining levels of estrogen at the onset of menses is likely to be the cause of menstrual migraines. Decreasing levels of estrogen also may be the cause of migraine headaches that develop among users of birth control pills during the week that estrogens are not taken.

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